The Impact of Tier 2 Mathematics Instruction on Second Graders with Mathematics Difficulties

A concerning number of students enter kindergarten facing an intractable variation of mathematics difficulties (MD). This study investigated the impact of an explicit, core kindergarten mathematics program on the mathematical outcomes of kindergartners who demonstrated risk for severe MD at kindergarten entry and examined whether these students improved from a category of high MD risk (i.e., <10th percentile) to a lower risk of MD (i.e., norm-referenced performance at or above the 10th, 20th, 30th, and 40th percentiles) between the fall and spring of kindergarten. Differential response to the program based on the classroom-level proportion of students with severe MD was also explored. A total of 795 kindergarteners with severe MD from 122 classrooms were included in the analyses. Results suggested students with severe MD in treatment classrooms improved from fall to spring at a greater rate than their control peers. Treatment students also demonstrated higher rates of improvement from below the 10th percentile to a performance at or above the 20th, 30th, and 40th percentiles across the school year. No evidence of differential efficacy of the program by the classroom-level proportion of students with severe MD was found. Implications for using explicit mathematics programs to thwart the onset of severe MD among academically vulnerable students are discussed.

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Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.14 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 14-14

Author(s):

Charu Aggarwal ◽

Melina Elpi Marmarelis ◽

Wei-Ting Hwang ◽

Dylan G. Scholes ◽

Aditi Puri Singh ◽

...

Keyword(s):

Clinical Practice ◽

Practice Change ◽

Molecular Testing ◽

Tier 2 ◽

Newly Diagnosed ◽

Next Generation ◽

First Line ◽

Tier 1 ◽

Tier 3 ◽

The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

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A Randomized Controlled Trial of the Impact of Schema-Based Instruction on Mathematical Outcomes for Third-Grade Students with Mathematics Difficulties

The Elementary School Journal ◽

10.1086/673199 ◽

2013 ◽

Vol 114 (2) ◽

pp. 252-276 ◽

Cited By ~ 19

Author(s):

Asha K. Jitendra ◽

Danielle N. Dupuis ◽

Michael C. Rodriguez ◽

Anne F. Zaslofsky ◽

Susan Slater ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Third Grade ◽

Randomized Controlled ◽

Third Grade Students ◽

Mathematics Difficulties ◽

Based Instruction ◽

The Impact

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The Effects of Tier 2 Mathematics Interventions for Students With Mathematics Difficulties: A Meta-Analysis

Council review ◽

10.1177/0014402920969187 ◽

2020 ◽

pp. 001440292096918

Author(s):

Asha K. Jitendra ◽

Ahmed Alghamdi ◽

Rebecca Edmunds ◽

Nicole M. McKevett ◽

John Mouanoutoua ◽

...

Keyword(s):

Variance Estimation ◽

Meta Analysis ◽

Experimental Studies ◽

Future Research ◽

Tier 2 ◽

Mathematics Interventions ◽

Treatment Groups ◽

Tier 2 Interventions ◽

Mathematics Difficulties ◽

Quasi Experimental

This meta-analysis examined the effectiveness of supplemental Tier-2 mathematics interventions for students with mathematics difficulties (MD). We reviewed 39 experimental and quasi-experimental studies that included 40 independent samples, with 61 treatment groups. Utilizing robust variance estimation (RVE), results revealed a treatment effect of 0.41. Mixed-effects meta-regression analyses revealed that Tier-2 interventions were moderated by intervention model type, group size, and type of measure. We present recommendations for future research and implementation of mathematics practices.

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Quantifying the Benefits of a Solar Home System-Based DC Microgrid for Rural Electrification

Energies ◽

10.3390/en12050938 ◽

2019 ◽

Vol 12 (5) ◽

pp. 938 ◽

Cited By ~ 4

Author(s):

Nishant Narayan ◽

Ali Chamseddine ◽

Victor Vega-Garita ◽

Zian Qin ◽

Jelena Popovic-Gerber ◽

...

Keyword(s):

Energy Deficit ◽

Rural Electrification ◽

Tier 2 ◽

Dc Microgrid ◽

Dc Microgrids ◽

Solar Home System ◽

Tier 3 ◽

Electricity Access ◽

The Impact ◽

Adequate Power

Off-grid solar home systems (SHSs) currently constitute a major source of providing basic electricity needs in un(der)-electrified regions of the world, with around 73 million households having benefited from off-grid solar solutions by 2017. However, in and of itself, state-of-the-art SHSs can only provide electricity access with adequate power supply availability up to tier 2, and to some extent, tier 3 levels of the Multi-tier Framework (MTF) for measuring household electricity access. When considering system metrics of loss of load probability (LLP) and battery size, meeting the electricity needs of tiers 4 and 5 is untenable through SHSs alone. Alternatively, a bottom-up microgrid composed of interconnected SHSs is proposed. Such an approach can enable the so-called climb up the rural electrification ladder. The impact of the microgrid size on the system metrics like LLP and energy deficit is evaluated. Finally, it is found that the interconnected SHS-based microgrid can provide more than 40% and 30% gains in battery sizing for the same LLP level as compared to the standalone SHSs sizes for tiers 4 and 5 of the MTF, respectively, thus quantifying the definite gains of an SHS-based microgrid over standalone SHSs. This study paves the way for visualizing SHS-based rural DC microgrids that can not only enable electricity access to the higher tiers of the MTF with lower battery storage needs but also make use of existing SHS infrastructure, thus enabling a technologically easy climb up the rural electrification ladder.

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Improving the Mathematics Performance of Second-Grade Students with Mathematics Difficulties through an Early Numeracy Intervention

Behavior Modification ◽

10.1177/0145445519873651 ◽

2019 ◽

Vol 45 (1) ◽

pp. 99-121 ◽

Cited By ~ 1

Author(s):

Diane Pedrotty Bryant ◽

Kathleen Hughes Pfannenstiel ◽

Brian R. Bryant ◽

Greg Roberts ◽

Anna-Mari Fall ◽

...

Keyword(s):

Mathematics Performance ◽

Second Grade ◽

Control Group ◽

Tier 2 ◽

Early Numeracy ◽

Control Group Design ◽

Second Grade Students ◽

Mathematics Difficulties ◽

Whole Number ◽

Tier 2 Intervention

The purpose of this study was to determine the effects of an early numeracy Tier 2 intervention on the mathematics performance of second-grade students with persistent mathematics difficulties. Whole number content and instructional design features were used to boost performance in second-grade early numeracy concepts and skills. Researchers employed a pretest-posttest control group design with randomized assignment of 83 students to the treatment condition and 38 students to the comparison condition. The research team’s mathematics interventionists delivered instruction four days per week for 20 weeks to small groups of second-grade students who were identified with persistent mathematics difficulties. Proximal and distal measures were used to determine the effects of the intervention. Findings showed that students in the treatment group outperformed students in the comparison group on the proximal measure of mathematics performance. There were no differences between groups on the problem-solving measures.

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The Impact of Capital Structure on Economic Capital and Risk Adjusted Performance

Astin Bulletin ◽

10.2143/ast.38.1.2030416 ◽

2008 ◽

Vol 38 (01) ◽

pp. 341-380 ◽

Cited By ~ 1

Author(s):

Bruce T. Porteous ◽

Pradip Tapadar

Keyword(s):

Capital Structure ◽

Asset Allocation ◽

Financial Services ◽

Stochastic Modelling ◽

Economic Capital ◽

Tier 2 ◽

Risky Assets ◽

Tier 1 ◽

The Impact ◽

Tier 1 Capital

The impact that capital structure and capital asset allocation have on financial services firm economic capital and risk adjusted performance is considered. A stochastic modelling approach is used in conjunction with banking and insurance examples. It is demonstrated that gearing up Tier 1 capital with Tier 2 capital can be in the interests of bank Tier 1 capital providers, but may not always be so for insurance Tier 1 capital providers. It is also shown that, by allocating a bank or insurance firm’s Tier 1 and Tier 2 capital to higher yielding, more risky assets, risk adjusted performance can be enhanced. These results are particularly pertinent with the advent of the new Basel 2 and Solvency 2 risk based capital initiatives, for banks and insurers respectively.

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Study protocol for COvid-19 Vascular sERvice (COVER) study: The impact of the COVID-19 pandemic on the provision, practice and outcomes of vascular surgery

10.1101/2020.05.27.20114322 ◽

2020 ◽

Author(s):

Ruth A Benson

Keyword(s):

Vascular Surgery ◽

Service Provision ◽

British Society ◽

Tier 2 ◽

Patient Level ◽

Tier 1 ◽

Ethical Approval ◽

The Uk ◽

Tier 3 ◽

The Impact

ABSTRACTBackgroundThe novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic.Methods and AnalysisThe COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN) with the support of numerous national (Vascular Society of Great Britain and Ireland, British Society of Endovascular Therapy, British Society of Interventional Radiology, Rouleaux Club) and an evolving number of international organisations (Vascupedia, SingVasc, Audible Bleeding (USA), Australian and New Zealand Vascular Trials Network (ANZVTN)). The study has 3 ‘Tiers’: Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from prepandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the prespecified statistical analysis plan.Ethical ApprovalEthical approval from the UK Health Research Authority has been obtained for Tiers 2 and 3 (20/NW/0196 Liverpool Central). Participating centres in the UK will be required to seek local research and development approval. Non-UK centres will need to obtain a research ethics committee or institutional review board approvals in accordance with national and/or local requirements.ISRCTN: 80453162 (https://doi.org/10.1186/ISRCTN80453162)Ethical Approval: 20/NW/0196 Liverpool Central, IRAS: 282224

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The Impact of the November 2020 English National Lockdown on COVID-19 case counts

10.1101/2021.01.03.21249169 ◽

2021 ◽

Author(s):

Paul R Hunter ◽

Julii Brainard ◽

Alastair Grant

Keyword(s):

Reproductive Rate ◽

Tier 2 ◽

New Variant ◽

Tier System ◽

Obvious Benefit ◽

Beneficial Impact ◽

R Value ◽

The Uk ◽

Tier 3 ◽

The Impact

In the UK the epidemic of COVID-19 continues to pose a significant threat to public health. On the 14th October the English government introduced a tier system for control of the epidemic but just 3 weeks later a National lockdown across all areas of England was implemented. When English areas emerged from Lockdown many were placed in different tiers (most typically moved up at least one tier). However, the effectiveness of the tier system has been challenged by the emergence of a new variant of SARS-CoV-2 which appears to be much more infectious. In addition, from early November a trial mass testing service was being run in Liverpool. We used publicly available data of daily cases by local authority (local government areas) and estimated the reproductive rate (R value) of the epidemic based on 7-day case numbers compared with the previous 7-day period. There was a clear surge in infections from a few days before to several days after the lockdown was implemented. But this surge was almost exclusively associated with Tier 1 and Tier 2 authorities. In Tier 3 authorities where hospitality venues were only allowed to operate as restaurants there was no such surge. After this initial surge, cases declined in all three tiers with the R value dropping to a mean of about 0.7 independent of tier. London, The South East and East of England Regions saw rising infection rates in the last week or so of lockdown primarily in children of secondary school age. We could find no obvious benefit of the trial mass screening programme in Liverpool city. We conclude that in Tiers 1 and 2 much of the beneficial impact of the national lockdown was lost probably because of the leak of its likely implementation five days early leading to increased socialising in these areas before the start of lockdown. We further conclude that given that the new variant is estimated to have an R value of between 0.39 and 0.93 greater than previous variants, any lockdown as strict as the November one would be insufficient to reverse the increase in infections by itself. The value of city-wide mass testing to control the epidemic remains uncertain.

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